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Intangible assets (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Total cost	$ 5,110,593	$ 5,109,212
Accumulated amortization	(946,183)	(830,553)
Net book value	4,164,410	4,278,659
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Total cost	4,077,267	4,076,435
Order backlog
Finite-Lived Intangible Assets [Line Items]
Total cost	537,247	536,934
Trade names & brands
Finite-Lived Intangible Assets [Line Items]
Total cost	204,640	204,621
Patient database
Finite-Lived Intangible Assets [Line Items]
Total cost	170,298	170,238
Technology assets
Finite-Lived Intangible Assets [Line Items]
Total cost	$ 121,141	$ 120,984

X

- Definition

Accumulated amount of amortization of assets, excluding financial assets and goodwill, lacking physical substance with a finite life.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 350
-SubTopic 30
-Section 50
-Paragraph 2
-Subparagraph (a)(1)
-URI https://asc.fasb.org/extlink&oid=66006027&loc=d3e16323-109275

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-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
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-URI https://asc.fasb.org/extlink&oid=120391452&loc=d3e13212-122682

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Amount before amortization of assets, excluding financial assets and goodwill, lacking physical substance with a finite life.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 928
-SubTopic 340
-Section 50
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-Name Accounting Standards Codification
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