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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, 2018 | Sep. 30, 2017 | Sep. 30, 2018 | Sep. 30, 2017
Segment Reporting Information [Line Items] |  |  |  |
Revenues | $ 11,451 | $ 10,696 | $ 34,403 | $ 32,052
Equity in earnings of affiliates | 9 | 13 | 25 | 36
Adjusted segment EBITDA | 2,096 | 1,776 | 6,441 | 5,871
Depreciation and amortization | 582 | 539 | 1,697 | 1,581
Interest expense | 442 | 427 | 1,309 | 1,257
Gain on sales of facilities | (6) | (7) | (420) | (10)
Losses on retirement of debt | 9 | 39 | 9 | 39
Income before income taxes | 1,069 | 778 | 3,846 | 3,004
National Group [Member] |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |
Revenues | 5,542 | 5,036 | 16,719 | 15,344
Equity in earnings of affiliates | (1) | (8) | (5) | (17)
Adjusted segment EBITDA | 1,127 | 975 | 3,593 | 3,268
Depreciation and amortization | 245 | 219 | 702 | 650
American Group [Member] |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |
Revenues | 5,396 | 5,180 | 16,113 | 15,268
Equity in earnings of affiliates | (10) | (9) | (29) | (27)
Adjusted segment EBITDA | 1,072 | 930 | 3,250 | 2,977
Depreciation and amortization | 258 | 251 | 765 | 727
Corporate and Other [Member] |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |
Revenues | 513 | 480 | 1,571 | 1,440
Equity in earnings of affiliates | 2 | 4 | 9 | 8
Adjusted segment EBITDA | (103) | (129) | (402) | (374)
Depreciation and amortization | $ 79 | $ 69 | $ 230 | $ 204

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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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