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Segment and Geographic Information - Schedule Of Geographic Distributions Of Revenues, Salaries And Benefits, Supplies, Other Operating Expenses, Equity In Earnings Of Affiliates, Adjusted Segment EBITDA, Depreciation And Amortization, Assets And Goodwill And Other Intangible Assets (Detail) - USD ($) $ in Millions | 12 Months Ended
--- | ---
Dec. 31, 2024 | Dec. 31, 2023 | Dec. 31, 2022
Segment Reporting Information [Line Items] |  |  |
Revenues | $ 70,603 | $ 64,968 | $ 60,233
Salaries and benefits | 31,170 | 29,487 | 27,685
Supplies | 10,755 | 9,902 | 9,371
Other operating expenses | 14,819 | 12,875 | 11,155
Equity in (earnings) losses of affiliates | (23) | (22) | (45)
Depreciation and amortization | 3,312 | 3,077 | 2,969
Interest expense | 2,061 | 1,938 | 1,741
Losses (gains) on sales of facilities | (14) | 5 | (1,301)
Losses on retirement of debt | 0 | 0 | 78
Income before income taxes | 8,523 | 7,706 | 8,580
Assets | 59,513 | 56,211 | 52,438
Goodwill and other intangible assets, Beginning Balance | 9,945 | 9,653 | 9,540
Goodwill and other intangible assets, Acquisitions | 170 | 362 | 262
Foreign Currency Translation Amortization And Other | (22) | (70) | (149)
Goodwill and other intangible assets, Ending Balance | 10,093 | 9,945 | 9,653
Operating Segments [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Adjusted segment EBITDA | 15,133 | 13,700 | 12,599
Eliminations and Reconciling Items [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Corporate and Other | 1,251 | 974 | 532
Depreciation and amortization | 3,312 | 3,077 | 2,969
Interest expense | 2,061 | 1,938 | 1,741
Losses (gains) on sales of facilities | (14) | 5 | (1,301)
Losses on retirement of debt | 0 | 0 | (78)
Income before income taxes | 8,523 | 7,706 | 8,580
National Group [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Goodwill and other intangible assets, Beginning Balance | 1,241 | 1,244 | 1,212
Goodwill and other intangible assets, Acquisitions | 0 | 0 | 75
Foreign Currency Translation Amortization And Other | (4) | (3) | (43)
Goodwill and other intangible assets, Ending Balance | 1,237 | 1,241 | 1,244
National Group [Member] | Operating Segments [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Revenues | 19,614 | 18,105 | 16,767
Salaries and benefits | 7,483 | 7,196 | 6,959
Supplies | 2,812 | 2,658 | 2,569
Other operating expenses | 4,892 | 4,253 | 3,624
Equity in (earnings) losses of affiliates | 2 | (2) | (1)
Operating expenses | 15,189 | 14,105 | 13,151
Adjusted segment EBITDA | 4,425 | 4,000 | 3,616
Depreciation and amortization | 857 | 834 | 801
Assets | 12,855 | 12,487 | 11,793
Atlantic Group [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Goodwill and other intangible assets, Beginning Balance | 2,064 | 2,057 | 1,970
Goodwill and other intangible assets, Acquisitions | 61 | 8 | 90
Foreign Currency Translation Amortization And Other | (1) | (1) | (3)
Goodwill and other intangible assets, Ending Balance | 2,124 | 2,064 | 2,057
Atlantic Group [Member] | Operating Segments [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Revenues | 23,171 | 21,167 | 19,324
Salaries and benefits | 8,525 | 8,058 | 7,752
Supplies | 3,553 | 3,331 | 3,088
Other operating expenses | 6,124 | 5,289 | 4,606
Equity in (earnings) losses of affiliates | (3) | (3) | (3)
Operating expenses | 18,199 | 16,675 | 15,443
Adjusted segment EBITDA | 4,972 | 4,492 | 3,881
Depreciation and amortization | 1,061 | 989 | 921
Assets | 17,168 | 16,098 | 15,092
American Group [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Goodwill and other intangible assets, Beginning Balance | 5,478 | 5,152 | 5,062
Goodwill and other intangible assets, Acquisitions | 105 | 326 | 90
Foreign Currency Translation Amortization And Other | 3 | 0 | 0
Goodwill and other intangible assets, Ending Balance | 5,586 | 5,478 | 5,152
American Group [Member] | Operating Segments [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Revenues | 24,601 | 22,318 | 20,858
Salaries and benefits | 8,529 | 8,080 | 7,757
Supplies | 4,035 | 3,616 | 3,331
Other operating expenses | 6,363 | 5,473 | 4,711
Equity in (earnings) losses of affiliates | (62) | (59) | (43)
Operating expenses | 18,865 | 17,110 | 15,756
Adjusted segment EBITDA | 5,736 | 5,208 | 5,102
Depreciation and amortization | 1,083 | 971 | 937
Assets | 20,714 | 19,786 | 17,934
Corporate and Other [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Revenues | 3,217 | 3,378 | 3,284
Depreciation and amortization | 311 | 283 | 310
Assets | 8,776 | 7,840 | 7,619
Goodwill and other intangible assets, Beginning Balance | 1,162 | 1,200 | 1,296
Goodwill and other intangible assets, Acquisitions | 4 | 28 | 7
Foreign Currency Translation Amortization And Other | (20) | (66) | (103)
Goodwill and other intangible assets, Ending Balance | $ 1,146 | $ 1,162 | $ 1,200

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