“…Mathematical and managerial tools strategies can help in reducing costs and in improving quality of healthcare services, from multi-criteria decision-making methods (Improta et al, 2019a, b;Ricciardi et al, 2020a;Sorrentino et al, 2020;Trunfio et al, 2020), to algorithms for biomedical data mining (Ricciardi et al, 2019a(Ricciardi et al, , 2020bD'Addio et al, 2020;Romeo et al, 2020) and analysis (Romeo et al, 2014(Romeo et al, , 2018Ricciardi et al, 2020c;Improta et al, 2020a), to novel process management and re-engineering techniques (Improta et al, 2019c;Montella et al, 2017;Converso et al, 2015;Cesarelli et al, 2020). Among the most common managerial techniques, the lean Six Sigma (LSS) methodology plays a considerable role (Improta et al, 2017(Improta et al, , 2018a.…”