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Segment and Geographic Information - Schedule of Geographic Distributions of Revenues, Equity in Earnings or Losses of Affiliates, Adjusted Segment EBITDA, Depreciation and Amortization (Detail) - USD ($) $ in Millions | 3 Months Ended | 9 Months Ended |
--- | --- | --- | ---
Sep. 30, 2025 | Sep. 30, 2024 | Sep. 30, 2025 | Sep. 30, 2024 | Dec. 31, 2024
Segment Reporting Information [Line Items] |  |  |  |  |
Revenues | $ 19,161 | $ 17,487 | $ 56,087 | $ 52,318 |
Salaries and benefits | 8,364 | 7,861 | 24,499 | 23,253 |
Supplies | 2,782 | 2,657 | 8,390 | 7,962 |
Other operating expenses | 4,161 | 3,717 | 11,799 | 10,946 |
Equity in (earnings) losses of affiliates | (16) | (15) | (53) | (13) |
Depreciation and amortization | 889 | 842 | 2,612 | 2,456 |
Interest expense | 561 | 515 | 1,676 | 1,533 |
Losses (gains) on sales of facilities | 2 | 4 | 4 | (209) |
Income before income taxes | 2,418 | 1,906 | 7,160 | 6,390 |
Assets | 59,747 |  | 59,747 |  | $ 59,513
Operating Segments [Member] |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Adjusted segment EBITDA | 4,267 | 3,567 | 12,480 | 10,996 |
Eliminations and Reconciling Items [Member] |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Corporate and Other | 397 | 300 | 1,028 | 826 |
Depreciation and amortization | 889 | 842 | 2,612 | 2,456 |
Interest expense | 561 | 515 | 1,676 | 1,533 |
Losses (gains) on sales of facilities | 2 | 4 | 4 | (209) |
Income before income taxes | 2,418 | 1,906 | 7,160 | 6,390 |
National Group [Member] | Operating Segments [Member] |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Revenues | 5,525 | 4,931 | 15,790 | 14,622 |
Salaries and benefits | 1,970 | 1,897 | 5,848 | 5,656 |
Supplies | 742 | 696 | 2,238 | 2,094 |
Other operating expenses | 1,466 | 1,270 | 3,954 | 3,668 |
Equity in (earnings) losses of affiliates | (1) | 0 | (1) | 2 |
Operating expenses | 4,177 | 3,863 | 12,039 | 11,420 |
Adjusted segment EBITDA | 1,348 | 1,068 | 3,751 | 3,202 |
Depreciation and amortization | 226 | 214 | 675 | 637 |
Assets | 13,274 |  | 13,274 |  | 12,855
Atlantic Group [Member] | Operating Segments [Member] |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Revenues | 6,142 | 5,738 | 18,431 | 17,429 |
Salaries and benefits | 2,288 | 2,190 | 6,750 | 6,500 |
Supplies | 889 | 858 | 2,738 | 2,651 |
Other operating expenses | 1,627 | 1,555 | 4,793 | 4,581 |
Equity in (earnings) losses of affiliates | (1) | 0 | (3) | (2) |
Operating expenses | 4,803 | 4,603 | 14,278 | 13,730 |
Adjusted segment EBITDA | 1,339 | 1,135 | 4,153 | 3,699 |
Depreciation and amortization | 281 | 271 | 830 | 790 |
Assets | 17,573 |  | 17,573 |  | 17,168
American Group [Member] | Operating Segments [Member] |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Revenues | 6,688 | 6,078 | 19,512 | 18,105 |
Salaries and benefits | 2,275 | 2,176 | 6,687 | 6,405 |
Supplies | 1,053 | 1,007 | 3,140 | 2,965 |
Other operating expenses | 1,796 | 1,549 | 5,156 | 4,689 |
Equity in (earnings) losses of affiliates | (16) | (18) | (47) | (49) |
Operating expenses | 5,108 | 4,714 | 14,936 | 14,010 |
Adjusted segment EBITDA | 1,580 | 1,364 | 4,576 | 4,095 |
Depreciation and amortization | 283 | 277 | 839 | 799 |
Assets | 20,889 |  | 20,889 |  | 20,714
Corporate and Other [Member] |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Revenues | 806 | 740 | 2,354 | 2,162 |
Depreciation and amortization | 99 | $ 80 | 268 | $ 230 |
Assets | $ 8,011 |  | $ 8,011 |  | $ 8,776

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