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Business Combinations - Narrative, PRA Acquisition (Details) $ / shares in Units, $ in Thousands |  | 12 Months Ended
--- | --- | ---
Jul. 01, 2021 Employee $ / shares shares | Dec. 31, 2022 USD ($) Employee | Dec. 31, 2021 USD ($) | Dec. 31, 2020 USD ($)
Business Acquisition [Line Items] |  |  |  |
Number of employees | Employee | 38,000 | 41,100 |  |
Transaction and one time financing costs |  | $ 0 | $ 75,391 | $ 0
PRA Health Sciences, Inc |  |  |  |
Business Acquisition [Line Items] |  |  |  |
Business acquisition, share price (in USD per share) | $ / shares | $ 80 |  |  |
Business acquisition, number of shares issued (in shares) | shares | 0.4125 |  |  |
Transaction and integration related (Note 6) |  | 39,700 | 198,300 |
Acquisition related costs |  | 800 | 57,100 |
Transaction and one time financing costs |  |  | $ 86,700 |
Gross debt issuance costs |  | $ 76,200 |  |

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- Definition This element represents acquisition-related costs incurred to effect a business combination which costs have been expensed during the period. Such costs include finder's fees; advisory, legal, accounting, valuation, and other professional or consulting fees; general administrative costs, including the costs of maintaining an internal acquisitions department; and may include costs of registering and issuing debt and equity securities. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 805 -SubTopic 10 -Section 25 -Paragraph 23 -URI https://asc.fasb.org/extlink&oid=123586518&loc=d3e1043-128460 + Details
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