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Segment Reporting (Detail) - USD ($)
$ in Thousands
 3 Months Ended 12 Months Ended
Dec. 31, 2017
Sep. 30, 2017
Jun. 30, 2017
Mar. 31, 2017
Dec. 31, 2016
Sep. 30, 2016
Jun. 30, 2016
Mar. 31, 2016
Dec. 31, 2017
Dec. 31, 2016
Dec. 31, 2015
Segment Reporting Information [Line Items]                      
Gross inpatient revenues                 $ 30,838,191 $ 27,060,212 $ 24,304,341
Gross outpatient revenues                 14,109,290 12,276,200 10,460,630
Total net revenues $ 2,642,787 $ 2,541,864 $ 2,612,356 $ 2,612,858 $ 2,475,685 $ 2,409,872 $ 2,430,855 $ 2,449,798 10,409,865 9,766,210 9,043,451
Income (loss) before allocation of corporate overhead and income taxes                 1,135,009 1,156,358 1,145,901
Allocation of corporate overhead                 0 0 0
Income (loss) after allocation of corporate overhead and before income taxes                 1,135,009 1,156,358 1,145,901
Total assets 10,761,828       10,317,802       10,761,828 10,317,802 9,615,444
Acute Care Hospital Services                      
Segment Reporting Information [Line Items]                      
Gross inpatient revenues                 21,888,207 19,042,627 16,847,944
Gross outpatient revenues                 13,115,881 11,374,098 9,604,952
Total net revenues                 5,484,683 5,112,950 4,632,564
Income (loss) before allocation of corporate overhead and income taxes                 641,857 557,472 519,630
Allocation of corporate overhead                 (182,713) (170,767) (197,699)
Income (loss) after allocation of corporate overhead and before income taxes                 459,144 386,705 321,931
Total assets 3,849,214       3,723,075       3,849,214 3,723,075 3,413,879
Behavioral Health Services                      
Segment Reporting Information [Line Items]                      
Gross inpatient revenues [1]                 8,949,984 8,017,585 7,456,397
Gross outpatient revenues [1]                 993,409 902,102 839,884
Total net revenues [1]                 4,906,719 4,645,007 4,400,335
Income (loss) before allocation of corporate overhead and income taxes [1]                 968,974 1,030,734 1,021,823
Allocation of corporate overhead [1]                 (158,735) (154,843) (117,203)
Income (loss) after allocation of corporate overhead and before income taxes [1]                 810,239 875,891 904,620
Total assets [1] 6,648,818       6,440,195       6,648,818 6,440,195 5,867,088
Other                      
Segment Reporting Information [Line Items]                      
Gross outpatient revenues                     15,794
Total net revenues                 18,463 8,253 10,552
Income (loss) before allocation of corporate overhead and income taxes                 (475,822) (431,848) (395,552)
Allocation of corporate overhead                 341,448 325,610 314,902
Income (loss) after allocation of corporate overhead and before income taxes                 (134,374) (106,238) (80,650)
Total assets $ 263,796       $ 154,532       $ 263,796 $ 154,532 $ 334,477
[1] Includes net revenues generated from our behavioral health care facilities located in the U.K. amounting to approximately $429 million in 2017, $241 million in 2016 and $203 million in 2015. Total assets at our U.K. behavioral health care facilities were approximately $1.098 billion as of December 31, 2017, $965 million as of December 31, 2016 and $521 million as of December 31, 2015.