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Segment and Geographic Information - Schedule of Geographic Distributions of Revenues, Equity in Earnings of Affiliates, Adjusted Segment EBITDA, Depreciation and Amortization and Assets (Detail) - USD ($) $ in Millions | 3 Months Ended | 9 Months Ended
--- | --- | ---
Sep. 30, 2017 | Sep. 30, 2016 | Sep. 30, 2017 | Sep. 30, 2016
Segment Reporting Information [Line Items] |  |  |  |
Revenues | $ 10,696 | $ 10,270 | $ 32,052 | $ 30,849
Equity in earnings of affiliates | 13 | 22 | 36 | 44
Adjusted segment EBITDA | 1,776 | 1,957 | 5,871 | 6,012
Depreciation and amortization | 539 | 495 | 1,581 | 1,463
Interest expense | 427 | 432 | 1,257 | 1,275
Gains on sales of facilities | (7) | (3) | (10) | (8)
Losses on retirement of debt | 39 | 4 | 39 | 4
Legal claim costs |  | 11 |  | 33
Income before income taxes | 778 | 1,018 | 3,004 | 3,245
National Group [Member] |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |
Revenues | 5,036 | 4,882 | 15,344 | 14,780
Equity in earnings of affiliates | (8) | (13) | (17) | (17)
Adjusted segment EBITDA | 975 | 1,073 | 3,268 | 3,342
Depreciation and amortization | 219 | 204 | 650 | 602
American Group [Member] |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |
Revenues | 5,180 | 4,908 | 15,268 | 14,554
Equity in earnings of affiliates | (9) | (9) | (27) | (26)
Adjusted segment EBITDA | 930 | 1,016 | 2,977 | 3,002
Depreciation and amortization | 251 | 231 | 727 | 675
Corporate and Other [Member] |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |
Revenues | 480 | 480 | 1,440 | 1,515
Equity in earnings of affiliates | 4 |  | 8 | (1)
Adjusted segment EBITDA | (129) | (132) | (374) | (332)
Depreciation and amortization | $ 69 | $ 60 | $ 204 | $ 186

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- Definition Income before depreciation and amortization, interest expense, losses (gains) on sales of facilities, losses on retirement of debt, legal claim costs, income taxes and net income attributable to non controlling interests. + References No definition available. + Details
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- Definition The aggregate expense recognized in the current period that allocates the cost of tangible assets, intangible assets, or depleting assets to periods that benefit from use of the assets. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 28 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=98514028&loc=d3e3602-108585 + Details
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- Definition Amount of gain (loss) on sale or disposal of property, plant and equipment assets, excluding oil and gas property and timber property. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 205 -SubTopic 20 -Section 50 -Paragraph 1 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=64827811&loc=d3e1361-107760 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 360 -SubTopic 10 -Section 50 -Paragraph 3 -URI http://asc.fasb.org/extlink&oid=84176398&loc=d3e2941-110230 + Details
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- Definition Difference between the fair value of payments made and the carrying amount of debt which is extinguished prior to maturity. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 470 -SubTopic 50 -Section 40 -Paragraph 2 -URI http://asc.fasb.org/extlink&oid=49170532&loc=d3e12317-112629 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 28 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=98514028&loc=d3e3602-108585 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 470 -SubTopic 50 -Section 40 -Paragraph 4 -URI http://asc.fasb.org/extlink&oid=49170532&loc=d3e12355-112629 + Details
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- Definition Amount of patient service revenue, net of contractual allowances and discounts, less the related provision for bad debts. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 954 -SubTopic 605 -Section 45 -Paragraph 4 -URI http://asc.fasb.org/extlink&oid=68054470&loc=SL9156442-115640 + Details
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