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Accounts receivable - Additional Information (Detail) $ in Thousands	9 Months Ended
	Sep. 30, 2017 USD ($)
Accounts Notes And Loans Receivable [Line Items]
Percentage of outstanding patient accounts receivables to be reserved as per Company's policy	100.00%
Account receivable outstanding, number of months	3 months
Decrease in allowance for doubtful accounts	$ 30,727
Government-based Programs, Medicare and Medicaid | Accounts Receivable
Accounts Notes And Loans Receivable [Line Items]
Percentage of outstanding patient accounts receivables to be reserved as per Company's policy	80.00%
Health Care Patient | Accounts Receivable
Accounts Notes And Loans Receivable [Line Items]
Percentage of accounts receivable due	1.00%
DMG
Accounts Notes And Loans Receivable [Line Items]
Percentage of outstanding patient accounts receivables to be reserved as per Company's policy	100.00%
Account receivable outstanding, number of months	12 months

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Patient accounts receivable months outstanding to be reserved per company policy.

+ References

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- Definition

Percentage of outstanding patient accounts receivables to be reserved when patient pay amounts due are outstanding for more than four months, as per the Company's policy.

+ References

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+ References

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- Definition

Amount of increase (decrease) in the allowance for doubtful accounts.

+ References

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- Definition

For an entity that discloses a concentration risk in relation to quantitative amount, which serves as the "benchmark" (or denominator) in the equation, this concept represents the concentration percentage derived from the division.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 275
-SubTopic 10
-Section 50
-Paragraph 18
-URI http://asc.fasb.org/extlink&oid=64851502&loc=d3e6351-108592

Reference 2: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
-SubTopic 10
-Section 50
-Paragraph 20
-URI http://asc.fasb.org/extlink&oid=73719730&loc=d3e13531-108611

Reference 3: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 275
-SubTopic 10
-Section 50
-Paragraph 20
-URI http://asc.fasb.org/extlink&oid=64851502&loc=d3e6404-108592

Reference 4: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
-SubTopic 10
-Section 50
-Paragraph 21
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=73719730&loc=d3e13537-108611

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