The Impact of Prioritisation and Eligibility Criteria on Social Services Intake Processes: An International Systematic Review (1993–2024)

Abstract

This systematic review examines the impact of prioritisation and eligibility criteria on social services’ intake processes. By analysing 22 studies from nine countries over three decades, this review identifies key patterns in how these criteria influence access to social assistance. Using thematic analysis, this study highlights that automation has improved efficiency by reducing administrative costs and wait times, but has also created access barriers for older adults, migrants, and individuals with limited digital skills. Additionally, gender and intersectionality play a crucial role, with men facing stricter eligibility requirements and migrant women experiencing higher approval rates. The findings also reveal that professionals’ subjective perceptions influence decisions, introducing biases that affect equitable resource distribution. While prioritisation systems streamline service delivery, they also lead to inconsistencies across different social service centres, potentially reinforcing social inequalities. This review emphasises the need to balance efficiency with fairness, ensuring that eligibility criteria do not become exclusionary mechanisms.

1. Introduction

The resources and benefits of social services are often insufficient to meet the existing demand (Minas 2005). In order to ensure equitable distribution and to deal with the most urgent or serious cases first, social service institutions establish admission and priority criteria (Hussénius 2019). These criteria, which have been regulated for years in countries such as Sweden, make it possible to organise the dispensing of resources and to ensure that the most critical situations receive preferential care (Andrén and Gustafsson 2004).

In 1969, Zimmerman (1969), investigating the intake process in a metropolitan county of a large western state in the United States (USA), described this phenomenon as a task ‘to gather and evaluate information concerning the set of eligibility factors defined for a particular assistance programme’ (p. 324). There was also a general trend towards the establishment of intake units in UK social services departments, one of the most popular organisational developments in Britain since Seebohm’s reorganisation (Gostick and Scott 1982). From the early 1970s, special intake units became widespread in Swedish social services (Hussénius 2019), progressively increasing the prevalence of these units up to the present day. In this regard, a survey of Swedish social welfare offices in 1989 showed that more than a quarter of all offices had an intake unit (Ranerup and Svensson 2023), and nine years later, intake units were identified in 64% of Swedish municipalities (Bergmark and Lundström 2016).

During initial contact, citizens seeking help are sorted according to certain eligibility criteria (Quirouette 2023), but also according to different intake procedures, with the consequence that some people receive an appointment for further assessment while others are referred to other institutions (Bergmark and Stranz 2022).

Social work professionals performing intake tasks deal with incoming calls and often carry out preliminary tests to assess the social needs of applicants (Altreiter and Leibetseder 2015). Therefore, it is imperative that information is clear during the first contact, and it is emphasised that social workers should make it clear that the information provided at this stage is only a preliminary assessment and not a formal assessment (Minas 2005).

In this respect, the organisation of intake in each social services centre can vary in complexity and tasks (Germundsson and Stranz 2023). In some centres, the professional responsible for the intake assesses the person’s demand and, in other centres, a first ‘means test’ is carried out directly to ascertain whether the person seeking help is likely to receive the presentation or social care he or she demands (Petersen et al. 2010). If it is the case, the person will receive an appointment with a social worker for further assessment (Stranz et al. 2016). However, in the event that the requirements for such care are not met, access professionals must inform individuals of their right to submit an application, regardless of the assessment of the intake officer (Bernhard and Wihlborg 2022). In addition to assessments, intake often provides information about other forms of assistance available in other institutions (Scott et al. 2002).

However, while both first contact and screening have been discussed, interest also focuses on the role of triage and categorisation of new clients (Andrén and Gustafsson 2004). In this way, the cases that are dealt with most quickly are those that are considered a priority (Germundsson and Stranz 2023). Those who receive a priority service do not go through the waiting list process, but receive a more or less immediate service, because their problems are considered urgent or their situation is precarious (Hydén 2016). In other words, the most operational criterion for priority is urgency. The urgency may be determined by the following: (1) the applicant’s situation, which has to be assessed as urgent by a competent professional; (2) the applicant’s own experience of the problem, for which they cannot tolerate waiting (Quirouette 2023). Some of the situations that have traditionally been considered a priority are as follows (Minas 2006): (1) situations that are likely to worsen quickly if the service is delayed, (2) cases in which users seem to be willing to seek help now but were not before, (3) cases in which a serious problem affects minors, (4) cases of very young and inexperienced people who need support, (5) cases in which there is a time limit on the situation itself. These prioritisation and ranking systems benefit social service centres and beneficiaries, as professionals have shorter waiting lists and beneficiaries have quicker access to the necessary care (Bernhard and Wihlborg 2022).

However, intake professionals have been found to have great discrepancies in assessing and deciding on individual social needs (Petersen et al. 2010). Several studies have shown substantial variations in assessments of similar cases by different professionals within the same social services centre (Minas 2006; Quirouette 2023). This disparity contrasts the principle of equality in access to public services and resources regardless of citizens’ place of residence (Hydén 2016).

Although several studies included in this introduction are based on the Swedish context due to the country’s long-standing development of intake and prioritisation systems in social services, this review does not focus exclusively on Sweden. It aims to provide an international perspective by analysing studies from a variety of national settings.

In this context, the aim of this review is to compile and synthesise the available evidence on the implications of the application of prioritisation and/or eligibility criteria in social services admission processes. Therefore, our review question is as follows: what are the implications of the application of prioritisation and/or eligibility criteria in social services’ intake processes?

2. Materials and Methods

2.1. Review Design Protocol

A systematic peer review was conducted. All steps taken in conducting this review were performed by two authors, and discrepancies were resolved by consensus or by consultation with a third investigator. This review was conducted according to the guidelines of the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement (Page et al. 2021) (refer to the supplemental material for the PRISMA checklist). In addition, we used as a reference chapter 20 of the Cochrane Handbook for Systematic Reviews of Interventions (Higgins and Deeks 2011), which provides useful information on how to conduct a systematic review from a methodological point of view.

Furthermore, this systematic review follows a qualitative, descriptive and comparative approach. The review is qualitative since it synthesises the results of empirical studies through thematic analysis. It also adopts a descriptive approach because it aims to characterise how prioritisation and eligibility criteria are applied in practice, rather than to test hypotheses or measure effects. Finally, it is a comparative approach because it examines studies conducted in different countries and institutional contexts, allowing for the identification of international similarities and differences in the application and implications of eligibility-based admissions processes.

2.2. Search Strategy

The search strategy aims to identify studies that analyse the subject of this study. A literature search was conducted in the databases Web of Science, Scopus, Pubmed Medline and PsycINFO ProQuest. The final and updated bibliographic search process was conducted between November and December 2024. No filters were applied for language, date of publication or free access to full text. Also, no filters for country of origin were applied. Therefore, the countries represented in the included studies were not deliberately chosen, but reflect the geographical contexts of the studies retrieved through the search strategy specified below.

After consulting the Medical Subjects Heading (MeSH) in Medline and the ProQuest Thesaurus, the terms ‘eligibility’, ‘determination’ and ‘social services’ were identified as keywords.

Table 1. Bibliographic search strategy in each database.

Database	Search Strategy
Web of Science	TS = (“intake” OR Admi*) AND TS = (Eligib* OR discret* OR Priori* Or Select*) AND TS = (“Social services” OR “Social Welfare” OR “Community Services” OR Social Service Intervention* OR Social Work Intervention* OR “Social Assistance” OR “Human Services”)
Scopus	TITLE-ABS-KEY (intake* OR admi*) AND TITLE-ABS-KEY (eligib* OR discret* OR priori* OR select*) AND TITLE-ABS-KEY (“Social services” OR “Social Welfare” OR “Community Services” OR social AND service AND intervention* OR social AND work AND intervention* OR “Social Assistance” OR “Human Services”)
Pubmed Medline	(“intake”[Title/Abstract] OR admi*[Title/Abstract]) AND (determination, eligibility[MeSH Terms] OR discret*[Title/Abstract] OR priori*[Title/Abstract] OR select*[Title/Abstract]) AND (Social services[MeSH Terms] OR Social Welfare[MeSH Terms] OR “Community Services”[Title/Abstract] OR social service intervention*[Title/Abstract] OR social work intervention*[Title/Abstract] OR “Social Assistance”[Title/Abstract] OR “Human Services”[Title/Abstract])
PsycINFO ProQuest	AB (“intake” OR admi*) AND AB (eligib* OR discret* OR priori* OR select*) AND AB (“Social services” OR “Social Welfare” OR “Community Services” OR social AND service AND intervention* OR social AND work AND intervention* OR “Social Assistance” OR “Human Services”)

shows the search strategies used in the different databases, using Boolean operators, truncators and tags.

In addition, an adaptation of the PICO tool (Higgins and Deeks 2011) was used for the design of the research question and database search strategies in this study. Concretely, we propose the use of “context” instead of “comparison”, which is more appropriate for this study (Stern et al. 2014), especially (1) for the population (people who request social services); (2) for the intervention (application of prioritisation and/or eligibility criteria in the admissions process); (3) for the context (diverse institutional and organisational social service settings); (4) for the outcome (implications in terms of equity, access, and system efficiency).

2.3. Selection of Studies

Two independent blinded reviewers reviewed the titles and abstracts of the full texts of the studies selected for inclusion in this review. Afterwards, the full article was examined in detail if at least one of the investigators had selected it during the title and abstract review phase. A third investigator resolved any discrepancies that arose during the full-text review. The inclusion criteria used were as follows: (1) primary research studies; (2) the type of study: article; (3) studies which assess the impact of prioritisation and/or eligibility criteria in social services admission processes. As exclusion criteria, the authors proposed the following: (1) secondary studies (reviews); (2) studies that did not report data on the subject matter of this study; (3) studies for which the full text was not available; (4) documents which were published in formats different from those of scientific articles (conference proceedings, book chapters, letters, etc.); and (5) studies which were conducted in contexts or institutions different from social services.

2.4. Data Extraction

Two reviewers independently compiled the main characteristics and findings of each selected study. Data were extracted and managed in piloted and adapted electronic files prior to the final assessment of all selected studies. To complete this stage of the study, the authors used a standardised data collection form, following the methodological recommendations proposed by Butler et al. (2016). The specific information extracted from each paper was as follows: title, authors, publication data, country, methodology used, the sample and the main results related to the consequences of the application of prioritisation and/or eligibility criteria in the social services admission processes.

2.5. Content Analysis

A narrative synthesis was used to identify the main findings of the included studies. Once the studies were selected, a thematic analysis was conducted using the Thematic Synthesis protocol to identify the main themes and sub-themes related to the study topic (Thomas and Harden 2008). For this stage, use was made of the EPPI-Reviewer 4 software (Thomas et al. 2010), which generates a template to store, sort and group (in codes and subcodes/themes and sub-themes) all the information that the reviewers consider appropriate according to the research questions and the phases of the thematic synthesis.

3. Results

3.1. Selection Process

The literature search and study selection process are shown in the PRISMA flow chart in Figure 1. The literature search yielded a total of 3233 references. After removing duplicate records (417 studies), a total of 2816 references were screened. During the second stage of the screening phase, 2757 studies were eliminated after independent peer review of the title and abstract, and discrepancies were resolved by third-party review. In addition, 12 studies were excluded in this step due to the inaccessibility of the full text of the papers. A total of 47 studies were selected for full-text peer review, our of which 25 references were eliminated after applying the proposed exclusion criteria: (1) studies that are not scientific articles (n = 4); (2) studies on a different topic (n = 15); and (3) studies conducted in settings or institutions other than social services (n = 6). Finally, 22 studies (Albers and Millar 1993; Alecu et al. 2024; Altreiter and Leibetseder 2015; Andreetta 2022; Bergmark and Stranz 2022, 2023; Considine et al. 2022; Gallagher et al. 2002; Germundsson and Stranz 2023; Germundsson 2024; Harpring et al. 2014; Hussénius 2019; Hussénius 2021a; Hussénius 2021b; Kallio and Kouvo 2014; Minas 2005; Minas 2006; Palacio 2021; Pithouse et al. 2011; Stranz et al. 2016, 2024; Tarone and Kuehn 2000) were included in the thematic synthesis of this systematic review.

3.2. Characteristics of the Studies Included

Table 2. Main characteristics of the studies included in this review.

Author and Year	Country	Design/Method of Data Collection	Sample Size
Albers and Millar (1993)	USA	Quantitative/survey	Total: 43 F: 33 M: 10
Alecu et al. (2024)	Norway	Quantitative/survey	Total: 925
Altreiter and Leibetseder (2015)	Austria	Qualitative/interview	Total: 84
Andreetta (2022)	Belgium	Qualitative/participant observation and interview	Total: 65
Bergmark and Stranz (2022)	Sweden	Quantitative/questionnaire	Total: 899 F: 782 M: 117
Bergmark and Stranz (2023)	Sweden	Quantitative/survey	Total: 1337 F: 1163 M: 117
Gallagher et al. (2002)	Russia	Qualitative/interview and focus group	Total: 34
Germundsson (2024)	Sweden	Qualitative/interview	Total: 14
Germundsson and Stranz (2023)	Sweden	Quantitative/questionnaire	Total: 705 F: 318 M: 387
Harpring et al. (2014)	USA	Quantitative/observation and recording	Total: 16
Hussénius (2019)	Sweden	Quantitative/questionnaire	Total: 423 F: 175 M: 248
Hussénius (2021a)	Sweden	Qualitative/questionnaire	Total: 910 F: 792 M: 118
Hussénius (2021b)	Sweden	Quantitative/questionnaire	Total: 899 F: 782 M: 117
Kallio and Kouvo (2014)	Finland	Quantitative/questionnaire	Total: 4007
Minas (2005)	Sweden	Quantitative/questionnaire and interview	Total: 548
Minas (2006)	Sweden	Quantitative/questionnaire	Total: 11
Palacio (2021)	Ecuador	Qualitative/interview	Total: 30
Pithouse et al. (2011)	England	Qualitative/interview and focus groups	Total: 90
Scott et al. (2002)	USA	Quantitative/register of case management services and register of treatment services	Total: 692 F: 322 M: 370
Stranz et al. (2016)	Sweden	Quantitative/questionnaire	Total: 423 F: 175 M: 248
Stranz et al. (2024)	Sweden	Quantitative/survey	Total: 705 F: 318 M: 387
Tarone and Kuehn (2000)	USA	Qualitative/interview	Total: 3 F: 2 M: 1

Note: Some studies do not specify the gender breakdown in the sample because they do not specify these data. The abbreviations used in this table are as follows: F = female; M = male.

lists the 22 studies included in the review. All of these studies address questions related to the impact of prioritisation and/or eligibility criteria on social services admission processes.

The studies cover a period of 31 years (1993–2024). The total sample consists of 12,863 participants, spread over nine countries. These countries are the following: United States (USA) (n = 4), Sweden (n = 11), Norway (n = 1), Belgium (n = 1), Finland (n = 1), Austria (n = 1), Russia (n = 1), Ecuador (n = 1) and England (n = 1). Figure 2 provides a choropleth map that clearly shows the global distribution of the publications included.

The gender distribution is unequal, with a predominant female representation in the studies. Specifically, taking as a reference the studies in which these data were specified, the participation of 2120 males and 4862 females was identified. Regarding the methodology used in the selected articles, 8 studies employed a qualitative methodology; 7 of these studies used the interview technique (Altreiter and Leibetseder 2015; Andreetta 2022; Gallagher et al. 2002; Germundsson 2024; Palacio 2021; Pithouse et al. 2011; Tarone and Kuehn 2000), two studies used the focus group technique (Gallagher et al. 2002; Pithouse et al. 2011), and 1 study used participant observation (Andreetta 2022) and one used the questionnaire (Hussénius 2021a). However, 14 articles used a quantitative methodology (Albers and Millar 1993; Alecu et al. 2024; Bergmark and Stranz 2022, 2023; Germundsson and Stranz 2023; Harpring et al. 2014; Hussénius 2019; Hussénius 2021b; Kallio and Kouvo 2014; Minas 2005; Minas 2006; Scott et al. 2002; Stranz et al. 2024). The quantitative methodology studies mainly used the data collection techniques of questionnaires (n = 8) and surveys (n = 4); logs (n = 2), interviews (n = 1) and observations (n = 1) were also used.

Table 2 provides a detailed overview of the main characteristics of the studies included in this review.

3.3. Thematic Analysis of the Results

From the analysis, four central descriptive themes common to the papers included in this review were developed inductively. These thematic areas, related to the impact of the application of prioritisation and/or eligibility criteria in social services intake processes, as well as the analytical approaches, are detailed in

Table 3. Main findings of the thematic synthesis.

Descriptive Themes	Analytical Approaches
Impact of automation on social care intake processes.	Optimisation vs. inequality. Reduction in professional discretion. Unintended consequences of using automation.
Gender perspective and its intersections in social welfare admissions.	Gender biases and stereotypes in the admissions process. Intersectionality of gender and origin in admissions processes. Differences in the assessment of paternity/maternity.
Methodological reforms and operational efficiency in social services admission processes.	One-stop-shop systems and their efficiency. Reduction in administrative costs and time spent on care. Balance between maximising resources and avoiding inequalities in access. Balance between speed and depth in assessments.
Impact of professionals’ subjectivity and perceptions on admission processes	Perception of professionals towards beneficiaries and its impact on decisions in admission processes. Role of professional training in relation to decisions in admissions processes.

.

3.3.1. The Impact of Automation on Social Care Intake Processes

After the analysis of the different papers included in this review on the impact of the application of prioritisation and/or eligibility criteria in social services intake processes, it was found that numerous studies (Albers and Millar 1993; Considine et al. 2022; Germundsson and Stranz 2023; Germundsson 2024; Minas 2005; Palacio 2021; Pithouse et al. 2011; Stranz et al. 2024) focus on investigating the impact of the implementation of computer systems and Robotic Process Automation (RPA) on intake processes and welfare distribution.

In line with the results of the selected studies, RPA and the use of other computerised systems in social intervention intake processes have generated a duality in its effects, simultaneously promoting the optimisation of resources and the creation of barriers for certain vulnerable groups. According to Albers and Millar (1993), the incorporation of computerised systems showed an improvement in the efficiency of resource allocation in services, with 76% of social service agency managers willing to participate in a centralised computerised system for the intake of beneficiaries. However, other studies, such as those by Germundsson and Stranz (2023) and Stranz et al. (2016), support the idea that the implementation of these technologies has led to inequalities in access to social services, especially for migrants and people over 50 years old, who have experienced difficulties interacting with standardised digital systems. Also, any welfare claimant with limited digital skills or without access to the necessary infrastructure may be excluded from the system (Considine et al. 2022).

In relation to the above, several authors support the idea that the introduction of RPA in the management of social intervention has contributed to a significant reduction in professional discretion. Studies by Germundsson (2024) and Stranz et al. (2024) argue that although RPA streamlines administrative tasks such as data transfer and information verification, it also limits the ability of social workers to assess cases on an individualised basis. This process has led to the standardisation of decisions, reducing flexibility in the assessment of applications and increasing the rigidity of eligibility criteria (Germundsson 2024; Pithouse et al. 2011). Therefore, Minas (2005) warns that the application of automated mechanisms in the classification of applicants may exclude individuals with complex situations who do not fit within the predefined parameters of the system. Social workers who have worked with computerised intake systems point out that, despite the virtues of technology in terms of risk assessment and risk reduction, on most occasions, the risk of providing a response that does not fit reality increases as it does not offer a flexible response (Pithouse et al. 2011).

The unintended consequences of automation in welfare systems have also been the subject of several studies. Stranz et al. (2024) concluded that digitisation has led to increased restrictiveness in the granting of benefits, with a 13% reduction in the approval of applications after the implementation of RPA. Similarly, a distance between social workers and the specific needs of beneficiaries has been documented, as automated systems have, in many cases, eliminated human interaction in decision-making (Considine et al. 2022; Pithouse et al. 2011). Furthermore, the application of algorithmic criteria for resource distribution has perpetuated institutional biases, disproportionately affecting less digitally literate groups (Palacio 2021; Pithouse et al. 2011).

Therefore, whereas social workers previously had the leeway to assess each application individually, the standardisation of processes through digital systems has reduced this flexibility, preventing personalised attention (Minas 2005; Stranz et al. 2024). As a result, RPA has been perceived as a mechanism that reinforces a stricter and more restrictive view in the granting of social assistance (Stranz et al. 2024).

In this regard, despite progress in this area in recent years, the digitisation of admissions processes raises tensions between efficiency and inclusiveness, and between consistency and personalisation, which still need to be resolved in practice (Considine et al. 2022). In addition, studies such as the one by Albers and Millar (1993) suggest that technical and organisational challenges such as software compatibility and data management also need to be addressed.

3.3.2. Gender Perspective and Its Intersections in Social Welfare Admissions

Continuing with the analysis of the studies included in this paper, another recurring theme was identified in several articles. This time, it was the study of welfare admission processes from a gender and intersectional perspective (Andreetta 2022; Bergmark and Stranz 2023; Hussénius 2019; Hussénius 2021a; Hussénius 2021b; Stranz et al. 2016, 2024; Tarone and Kuehn 2000).

After analysing social services admission processes from a gender perspective, biases and inequalities in the distribution of social resources were identified. In this regard, Hussénius (2019) and Stranz et al. (2016) support the idea that men face stricter requirements when their applications are assessed, assuming that they must be the main breadwinners of the family unit. Along these lines, several studies support the idea that women are more likely to receive social assistance (Andreetta 2022), although this likelihood decreases when they are perceived by professionals to use alcohol or other drugs (Hussénius 2019; Stranz et al. 2016).

On the other hand, several studies point out that intersectionality between gender and origin also affects the rates at which social resources are granted (Bergmark and Stranz 2023; Hussénius 2021a; Tarone and Kuehn 2000). In this sense, women of foreign origin are more likely to receive social assistance than native men (Hussénius 2021a; Tarone and Kuehn 2000). This is because immigrant women have fewer opportunities to enter the labour market and therefore require government support (Bergmark and Stranz 2023).

In contrast, studies show that applicants with Swedish names have higher approval rates for social resources than those with Arabic names (Hussénius 2021a). However, this is at odds with the findings of studies such as the one by Tarone and Kuehn (2000), who support the idea that, in the assessment process for foreign nationals, their responses, or lack thereof, often suggested that they did not understand all the information being conveyed by the interviewer. The consequences of misunderstanding in this context can be serious: claimants may receive less benefits than they deserve or even commit welfare fraud without realising it (Hussénius 2021b).

In line with the above, differences in the assessment of paternity and maternity are another determinant of access to social assistance. The study by Stranz et al. (2024) points out that single mothers face fewer administrative obstacles compared to single fathers, who tend to be assessed under stricter criteria. In this sense, social workers tend to consider single mothers more legitimate recipients of support, whereas single fathers are required to demonstrate more proof of inability to generate income (Andreetta 2022; Hussénius 2019).

3.3.3. Methodological Reforms and Operational Efficiency in Social Services Intake Processes

Regarding the impact of eligibility and prioritisation criteria on social services intake processes, several studies investigate the efficiency of such methodological reforms for the system (Bergmark and Stranz 2022, 2023; Gallagher et al. 2002; Germundsson 2024; Harpring et al. 2014; Minas 2005; Minas 2006; Scott et al. 2002; Stranz et al. 2024).

Studies from different countries, such as the USA and Russia, support the idea that the implementation of intake processes in social services has improved the efficiency of the social welfare system. Authors such as Scott et al. (2002) support the idea that the implemented one-stop-shop systems have reduced administrative costs and decreased the time spent with clients. In particular, the implementation of the one-stop-shop system in Arzamas (Russia) has been shown to reduce the time needed to apply for social care by 30–44% in order to increase the case handling capacity of social services staff (Gallagher et al. 2002).

In addition, social services intake processes have reduced the administrative workload of social workers, leading to improved beneficiary experience and satisfaction (Germundsson 2024; Stranz et al. 2024).

However, not all studies show a high level of citizen satisfaction with social services admission systems. Some social service centres employ selective strategies, such as referrals to other agencies or requiring additional information, which may delay or deter access to social care (Bergmark and Stranz 2023). In addition, the autonomy granted to each centre to apply its own admission criteria contributes to variability in management, generating inequalities in access to services (Minas 2005).

Other authors such as Bergmark and Stranz (2022) and Minas (2006) point out in their studies that high caseloads can reduce the depth of assessments and affect the quality of the service provided. In this regard, several studies have found that intake processes can reduce the waiting list through prioritisation and eligibility processes (Bergmark and Stranz 2023).

Ultimately, although the implementation of intake systems in social services may entail limitations in the functioning of the system (Bergmark and Stranz 2022; Minas 2006), there is evidence of greater satisfaction on the part of professionals and beneficiaries, as well as faster case processing times (Harpring et al. 2014). Along these lines, studies such as the one by Gallagher et al. (2002) report that the use of intake systems improved staff efficiency, from processing 85 cases per month to 127 per member, and reduced the time beneficiaries spent in the process, saving between 1.3 and 2.4 h per application. In addition, the implementation of these systems has not only allowed for greater flexibility in the use of resources, better case management and more efficient monitoring of services, but has also resulted in administrative cost savings due to the unification of intake staff functions (Minas 2006).

3.3.4. Impact of Professionals’ Subjectivity and Perceptions on Admission Processes

Social workers’ perception of beneficiaries is variable and influences the legitimacy of receiving social assistance (Alecu et al. 2024; Altreiter and Leibetseder 2015; Andreetta 2022; Bergmark and Stranz 2022, 2023; Hussénius 2021b; Kallio and Kouvo 2014; Palacio 2021).

Studies such as Altreiter and Leibetseder (2015) and Bergmark and Stranz (2023) reveal that the construction of deservingness of social care varies in each municipality and is influenced by values and moral assumptions of professionals. These ideologies affect the way in which beneficiaries are treated because, as professionals have room for manoeuvre in the interpretation of a person’s situation, social policies can be implemented in an unequal manner (Andreetta 2022; Kallio and Kouvo 2014). Alecu et al. (2024), in their study, show that social workers’ cognitive attitudes influence their willingness to sanction beneficiaries who fail to comply with requirements. Specifically, perceiving clients as manipulative, dishonest or stubborn increases the likelihood of imposing sanctions (Alecu et al. 2024; Palacio 2021).

In this regard, social workers tend to view welfare recipients positively, considering them deserving of care (Bergmark and Stranz 2022). However, there are notable differences in perceptions among professionals. Findings from one study indicated that social workers who interact closely with beneficiaries have a more favourable view of their deservingness, whereas those who do not have such direct or continuous contact with beneficiaries are more critical (Andreetta 2022).

This discrepancy also partly coincides with the lack of training of professionals. Kallio and Kouvo (2014) point out that the lack of training on the part of some professionals leads them to rely on stereotypes at the time of assessment, rather than having a thorough understanding of the circumstances of the beneficiaries. In this vein, non-specialised staff may increase the risk of biassed assessments and arbitrary decisions (Bergmark and Stranz 2022, 2023).

On the other hand, the fact that practitioners have had personal experience with social assistance also influences perceptions: those who have received social assistance or have family beneficiaries tend to have more positive attitudes than those who have not had this experience (Hussénius 2021b). In addition, the political ideology of professionals also plays an important role in how social problems and poverty are perceived, suggesting that political ideologies influence case processing (Andreetta 2022; Kallio and Kouvo 2014).

4. Discussion

The aim of this review was to analyse the impact of the application of prioritisation and eligibility criteria in the intake processes of social services. Through the synthesis of the selected studies, we have sought to identify the central themes that emerge in the analysis of this issue. Based on the findings obtained, we can suggest useful tools for the improvement of admission processes and open up new lines of research in this sphere.

First, it is evident that digitisation and automation in intake processes have had a significant impact on the operational efficiency of social services (Germundsson 2024; Stranz et al. 2024). While the implementation of automated prioritisation systems has reduced administrative time and increased case management capacity, it has also posed challenges in terms of social exclusion and accessibility. Several studies have pointed out that people with digital limitations, especially older people and migrants, find it difficult to navigate automated systems which can restrict their access to services (Considine et al. 2022; Palacio 2021). These findings are in line with the results of other studies such as the one by Benavides-Franco et al. (2023), who point out that although technology is often associated with integration, it can also isolate people, creating new forms of social exclusion. In this regard, it is considered necessary to identify and reduce digital skills gaps by training citizens and implementing automation processes progressively (Wirtz et al. 2023).

In relation to professional discretion, findings indicate that the introduction of automation has reduced the ability of social workers to assess cases on an individualised basis, leading to standardisation in decision-making (Pithouse et al. 2011; Stranz et al. 2024). Therefore, although this process contributes to greater equity in the allocation of resources, it also limits flexibility in the assessment of complex situations that do not fit predefined parameters (Minas 2005). In this sense, it is necessary to balance operational efficiency with the capacity to adapt to particular cases, avoiding the exclusion of people with specific needs.

Applying a gender perspective, the review has identified gender-differentiating patterns in the processes of admission to social services. Studies show that men face stricter requirements to access assistance, while women are more likely to receive social support (Hussénius 2019; Stranz et al. 2016). These findings are in line with other studies that highlight the feminisation of poverty and the gender gap that continues to exist at the multidimensional level, which calls for greater support and assistance measures for this group (Covarrubias 2023; Sharma 2023). However, a situation in which women are more likely to receive social support is reversed in cases where they are perceived to be drug or substance users, reducing their eligibility for assistance (Hussénius 2021a). In addition, gender biases are related to ethnicity, showing that migrant women are more likely to receive help than native men (Bergmark and Stranz 2023). Along these lines, studies such as the one by Lavee et al. (2022) report higher rates of social exclusion and poverty among women who are migrants. These findings underline the importance of incorporating an intersectional approach in the formulation of admissions policies, ensuring equitable access to social services.

Another issue to highlight is the impact of methodological reforms on the efficiency of intake processes. The implementation of one-stop-shop systems has been shown to improve the speed of care and reduce the administrative burden on social workers (Gallagher et al. 2002; Scott et al. 2002). However, some studies warn of the risk that these systems generate inequalities in access, depending on the autonomy of each centre in the application of admission criteria (Bergmark and Stranz 2023). It has also been observed that the prioritisation of urgent cases may affect the quality of the assessment of applications, as social workers have to manage a high volume of cases in short time frames (Minas 2006). Therefore, future research should address the balance between operational efficiency and the quality of intake processes.

Finally, social workers’ perceptions of beneficiaries play a fundamental role in the application of eligibility criteria. Some studies show that professionals may develop biases based on the perception of deservingness, which influences decision-making on the granting of assistance (Altreiter and Leibetseder 2015; Palacio 2021). Along these lines, other research has concluded that certain social work practices are influenced by biases and prejudices on the part of professionals, making it imminently necessary to include these aspects in the training of social workers (Bussey et al. 2021). In relation to the above, studies included in this review highlight that the training of social workers affects their ability to objectively assess requests for help, pointing to the need to implement training programmes that reduce the influence of stereotypes and personal biases (Bergmark and Stranz 2022; Kallio and Kouvo 2014). These findings are in line with other studies that indicate that the training of social workers directly influences the care that professionals provide to beneficiaries (Lee et al. 2022).

In terms of future lines of research, it would be relevant to explore how the implementation of more advanced and current technologies, such as artificial intelligence, can improve the personalisation of intake processes without compromising equity. Although there are studies that investigate the impact of artificial intelligence on social services (Vallejo-Andrada et al. 2024), it would be opportune to investigate how artificial intelligence can optimise admission processes to social services. Studies are also needed to analyse beneficiaries’ perceptions of these intake systems and their impact on trust in social services. In addition, future research could extend the results to generate a more robust body of knowledge, enabling social workers to develop the necessary skills and make better decisions in the application of intake criteria. These new data could guide professional regulation and training in evidence-based and ethical decision-making.

In addition, there is a considerable heterogeneity in terms of the transparency and clarity with which the prioritisation and eligibility criteria are presented in the processes of admission to social services. Whereas some studies identify these criteria in a general and undeveloped way, others do not specify them at all, making it difficult for citizens to understand and evaluate them. This lack of standardisation and accessibility of information can negatively affect the fairness of the system, as the absence of clear and shared criteria hinders the possibility of guaranteeing fair and transparent access. Moreover, the wide autonomy granted to the centres to apply their own criteria generates considerable variability in management, which, as Minas (2005) warned, can lead to territorial inequalities. In this way, more recent studies (Bergmark and Stranz 2023) point out that the differentiated implementation of admission criteria, depending on the institutional context, can amplify disparities in access to resources. With regard to these findings, a specific analysis of transparency in the application of prioritisation and eligibility criteria is proposed as a line of future research; the development of common frameworks that promote greater coherence between territories and reduce inequalities derived from discretionality in their application is also encouraged.

This systematic review is not exempt from limitations. Although we searched the major databases containing studies on the topic of interest, searching other databases might have revealed relevant scientific articles published in lower-impact journals, or official reports on this topic. In addition, the key terms used to conduct the searches were all in English; therefore, while we did not exclude studies on the basis of language, it is possible that some relevant research may have been missed. Another limitation of this systematic review is that no standardised tool was used to assess the methodological quality of the included studies. While the review followed the PRISMA guidelines and employed a rigorous and transparent search and selection process, other tools such as the Standards for Qualitative Research Reporting (SRQR), CASP or MMAT were not applied. This decision was based on the exploratory nature of the review and the methodological heterogeneity of the selected studies, which included both qualitative and quantitative designs. The diversity of research approaches made it difficult to apply a single quality assessment tool uniformly across all studies.

Furthermore, regarding factors such as country of birth and family status, although they were present in a secondary way in some of the included studies, they were not addressed as independent thematic axes in the main analysis. These elements were considered in a intersectional way, mainly in relation to the gender perspective, which limited the possibility of delving into their specific influence on eligibility processes. This issue is recognised as a limitation of the study, since these factors constitute relevant social factors that can significantly influence decisions on access to social services. Therefore, it underlines the need for future research to adopt a more focused approach to explore these variables in depth.

5. Conclusions

In conclusion, the use of prioritisation and eligibility criteria in the intake processes of social services has been proven to improve efficiency and optimisation of resources, but it also poses challenges in terms of equity and accessibility. In this regard, automation has reduced waiting times and administrative costs, but has simultaneously generated barriers for certain groups, such as older adults, migrants and people with limited digital skills. In order to mitigate these negative effects, it is crucial to continue researching strategies to ensure that these criteria do not become mechanisms of exclusion, but tools that facilitate access for those who need it most. In addition, the incorporation of emerging technologies, such as artificial intelligence, could improve the personalisation of processes without compromising equity. This review provides valuable information for the formulation of public policies and intervention strategies that promote fairer and more efficient management of social resources.