Abstract. The ongoing processes of restructuring the network of medical organizations and their reorganization reduce the availability of qualified medical and preventive care to rural residents, which in modern conditions actualizes the problem of the need to correct the existing system of medical care for the rural population, return the leading role of central regional hospitals in providing rural residents with all types of medical care. The purpose Assess the dynamics of changes in the network of central district and district hospitals and their capacity. Methods Data from Rosstat, Ministry of Health of Russia, FGBI "CRIHOI" of the Ministry of Health of Russia. Used analytical, statistical methods and comparative analysis. Results The number of central district hospitals for the period 2015-2019 in the whole of the Russian Federation decreased by 101 (by 7.1%), of which in rural areas - by 61 (by 10.2%), the number of beds in the Central Regional Hospital - by 28200 (by 13.7%). The number of district hospitals remained unchanged. The share of central rayon and rayon hospitals in rural areas decreased from 42.5% in 2015 to 42.2% in 2019. These hospitals have become more weak. The total number of beds in central district and district hospitals has decreased by more than 30 thousand. Not only beds of narrowly specialized profiles have significantly decreased, but also therapeutic, surgical, pediatric and beds for pregnant women and women in labor. Moreover, the largest share of reduced beds is observed in subjects with a prevailing share of the rural population. Discussion The rate of bed availability in the Central District Hospitals and District Hospitals for the rural population declined at a faster rate than the bed availability rate for the general population, despite the decline in the rural population and its share. Inter-municipal centers of specialized care, created on the basis of large central regional hospitals, cannot replace the daily regular activity of regional (central) hospitals to organize qualified medical care for the rural population. Conclusion. The further reduction in the number of central rayon and rayon hospitals and their beds should be stopped. In order to improve the quality and availability of qualified medical care for rural residents and residents of small towns and villages, it is necessary to envisage large-scale construction of hospitals of this type according to modern standard projects, equipping them with the necessary equipment and qualified personnel.