The fragmentation of medical care, the unsatisfactory situation with the continuity of the stages of medical care, the lack of economic interest in the development and promotion of certain types of medical care led to a decrease in the rate of development of hospital-substituting technologies and the efficiency of day hospitals. The purpose of this work was to study the dynamics of the total number of beds in day hospitals of all types for children, indicators of their provision and activities, as well as in-patient hospitals for children in the Russian Federation and its subjects over the period 2003-2018. Methods Analytical, including comparative analysis, statistical Results The number of beds in the DS for children, as well as the indicator of their provision in the Russian Federation as a whole, increased over the period 2003-2018, however, their dynamics is negative in a number of subjects. The efficiency of use of beds in day hospitals for children has decreased. There is a regressive development of home hospitals for children. In 20 subjects, home hospitals for children did not function at all during the observed period, and in 20 subjects were eliminated by the end of the observed period. The average duration of treatment in hospitals at home varies by subject and by year within subjects at times. Conclusion A rethinking is needed in the approaches to the development of hospital-substituting technologies in modern conditions, both on the part of the MHI Fund, the health authorities and heads of medical organizations. There is a need for regulations approving the order of organization and indications for treatment in day hospitals and in-patient hospitals in order to actually improve the quality and accessibility of medical care for the population, in particular for children, and for increasing the role and effectiveness of primary health care.