This two volume report is the first of a five-part study to determine ways and means of facilitating horizontal and vertical mobility within New York City's Health Services Administration and selected private hospitals. It seeks to answer two questions: (1) Does the structure of the municipal hospital system permit the efficient planning, development, and use of health manpower? and (2) What structures will permit the achievement of these objectives? Volume I examines how employment and mobility are affected by institutional and economic factors in the system. Concluding that institutional change is needed, long- and short-run solutions are suggested, focusing on career pathways for: (1) medical-type human interaction jobs, (2) non-medical human interaction jobs, (3) plant, equipment, and materials-related jobs, and (4) information-related jobs. The appendixes presented in Volume II are technical and statistical and reflect the data collection process, including: (1) the code books, supplements, and descriptions of the data, (2) a summary of the data base and a listing of all the coded data collected, and (3) a large fold-out chart showing all the job titles studied, grouped by major function and arranged according to wage level. (JK)