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Dispositions and acquisitions - Additional Information (Detail) (USD $)
In Millions, unless otherwise specified
 6 Months Ended 6 Months Ended 6 Months Ended
Jun. 30, 2012
Jun. 30, 2012
Ascend Health Corporation
State
Facility
Jun. 30, 2011
Acute Care Hospital Services
Jun. 30, 2012
Hospital San Juan Capestrano
Jun. 30, 2012
Auburn Regional Medical Center
Significant Acquisitions and Disposals [Line Items]          
Business acquisition, cash paid   $ 500      
Business acquisition, assumed liabilities   17      
Business acquisition, purchase price   517      
Number of psychiatric inpatient facilities   9      
Number of states facilities located   5      
Acquisition of a physician practice and various real properties 11        
Return of deposit on terminated purchase agreement 6.5        
Aggregate cash proceeds from divestiture of businesses 53       98
Number of acute care hospital beds included in sale       108 213
Net cash proceeds from the sale of a closed acute care hospital     $ 2