Can a hospital in Peru move you to another hospital in an emergency without your consent, and who pays for the transfer?

If they cannot treat you, they must refer you

The duty to treat an emergency binds every health facility. Article 3 of the General Health Law:

Toda persona tiene derecho a recibir, en cualquier establecimiento de salud, atención médico quirúrgica de emergencia cuando lo necesite, estando los establecimientos de salud sin excepción obligados a prestar esta atención, mientras subsista el estado de grave riesgo para su vida y salud.

(Everyone has the right to emergency medical and surgical care in any health facility, and every facility, without exception, must provide it while the serious risk to life and health lasts.)

Not every facility can handle every case. For that, article 6 of Decreto Supremo 027-2015-SA sets the way out:

Si ésta no contase con la capacidad resolutiva necesaria, deberá referirlo de inmediato a un establecimiento de mayor nivel.

(If the facility lacks the capacity needed to resolve the case, it must refer the patient at once to a higher-level facility.)

In Peru a health facility is called an IPRESS. What the rule requires is a referencia: the facility sends the patient on. It does not say “tell the family to look for another hospital”.

Before moving you, they stabilise you

The regulation of the emergency-care law (DS 016-2002-SA) adds two rules. Article 7:

El responsable de la atención de emergencia, debe tomar las medidas necesarias para asegurar la adecuada valoración médica de los pacientes, su tratamiento, o la estabilización de sus condiciones generales en caso necesiten ser transferidos a otros establecimientos.

(The person in charge of emergency care must make sure patients are properly assessed, treated, or stabilised if they need to be transferred.)

And article 8, for when the specialist is missing:

Cuando los recursos del establecimiento no permitan brindar la atención especializada que el paciente requiera, se procederá a convocar al profesional especialista necesario o a transferir al paciente a otro establecimiento que esté en posibilidad de brindar la atención requerida de acuerdo a las normas de referencia y contrarreferencia, aprobados por el Ministerio de Salud.

(If the facility cannot provide the specialised care needed, it must call in the specialist or transfer the patient to a facility that can, following the Ministry of Health’s referral rules.)

Two things follow. The destination must be a facility that can give the care you need. And the transfer follows a Ministry of Health procedure; it is not improvised. We do not explain that procedure in detail here (see the warning above).

You have the right to know why, and to say no

The General Health Law, article 15.2 d), says everyone has the right:

A recibir información completa de las razones que justifican su traslado dentro o fuera del establecimiento de salud, otorgándole las facilidades para tal fin, minimizando los riesgos. El paciente tiene derecho a no ser trasladado sin su consentimiento, salvo razón justificada del responsable del establecimiento. Si no está en condiciones de expresarlo, lo asume el llamado por ley o su representante legal.

(To full information on the reasons for a transfer within or outside the facility, with the means to carry it out and risks kept to a minimum. The patient has the right not to be moved without consent, unless the person in charge of the facility has a justified reason. If the patient cannot give consent, the person the law designates or the legal representative does.)

Article 14 of DS 027-2015-SA repeats the right and adds that you must also be told «las condiciones en que se realizará» (how the transfer will be done).

Asking for the transfer yourself

Many families want to take a patient out of an overcrowded hospital to a private clinic, or to their EsSalud hospital. Article 14 of DS 027-2015-SA allows it, with conditions:

La persona usuaria o su representante […] podrá solicitar su traslado a otra IPRESS, de acuerdo a las condiciones de su cobertura, siempre que: exprese su voluntad por escrito, su estado de salud lo permita y su situación de salud, determinada por el médico, así lo requiera.

(The patient or their representative may ask to be moved to another facility, according to their cover, provided they ask in writing, their health allows it, and their situation, as determined by the doctor, requires it.)

All three conditions apply at once.

Once the emergency is over, the rule is simpler. Article 12 of DS 016-2002-SA:

Luego que la persona atendida en un establecimiento de salud no presente ningún riesgo para su vida o su salud, reembolsará los gastos ocasionados por su atención, siendo de su responsabilidad, de sus familiares o de sus representantes legales, decidir en qué establecimiento de salud continuará su tratamiento.

(Once the patient is no longer at any risk, they pay for their care, and it is up to them, their family or legal representatives to decide where treatment continues.)

Who keeps you safe on the way, and who pays

Article 14 of DS 027-2015-SA ends like this:

La IPRESS debe garantizar la seguridad de la persona usuaria durante el traslado, sin perjuicio de su derecho de solicitar a la IAFAS el reembolso por los gastos incurridos, siempre que forme parte de la cobertura prestacional a que la persona usuaria tiene derecho en su IAFAS.

(The facility must guarantee the patient’s safety during the transfer, and may claim the cost from the patient’s insurer if the transfer is part of the patient’s cover.)

IAFAS is the technical name for whoever funds your care: SIS, EsSalud, an EPS or a private insurer.

What this page does not cover

We do not explain the content of MINSA’s technical rule on referral and counter-referral, because we could not read its official text. We do not detail the SIS or EsSalud benefit plans, or the rules of an EPS or a private insurer. We do not cover transfers after road accidents paid by SOAT, or criminal liability if a badly handled transfer causes harm. If you think there was malpractice, start with medical malpractice in Peru.