The article presents analysis of the system of organization of primary medical sanitary care in the Russian Federation, its strong and weak aspects are emphasized. The main indices of out-patient care of population and their dynamics are considered. The necessity of system development is substantiated with the purpose of supporting accessibility and quality of medical care in out-patient conditions. The concept of development of organizational functional model of primary medical sanitary care in actual conditions is presented. The main principles of the proposed model are founded on implementation of structural transformation of polyclinics with organization of departments of general practitioner practice, specialized consultative care, medical prevention, diagnostic, medical rehabilitation, medical social care, day-time hospital.