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Acquisitions and Dispositions - Additional Information (Detail) $ in Thousands | 9 Months Ended
--- | ---
Sep. 30, 2018 USD ($) Hospital | Sep. 30, 2017 USD ($) Hospital
Business Acquisition [Line Items] |  |
Number of hospitals purchased | Hospital | 2 | 7
Proceeds from sale of business | $ 802,000 | $ 24,000
Real Estate and Other Investments [Member] |  |
Business Acquisition [Line Items] |  |
Pretax gain (loss) on sales of business | 48,000 | 10,000
Proceeds from sale of business | 44,000 | 24,000
Discontinued Operations, Disposed of by Sale [Member] | Oklahoma [Member] |  |
Business Acquisition [Line Items] |  |
Pretax gain (loss) on sales of business | 372,000 |
Proceeds from sale of business | $ 758,000 |
Number of hospitals sold | Hospital | 2 |
Hospitals [Member] |  |
Business Acquisition [Line Items] |  |
Aggregate purchase price | $ 788,000 | 1,000,000
Nonhospital Health Care [Member] |  |
Business Acquisition [Line Items] |  |
Aggregate purchase price | 268,000 | 142,000
Other [Member] |  |
Business Acquisition [Line Items] |  |
Fair value of identifiable net assets of acquired entities | $ 433,000 | $ 655,000

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