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Property and Equipment
 12 Months Ended
Dec. 31, 2023
Property, Plant and Equipment [Abstract]  
Property and Equipment Property and equipment
Property and equipment comprised the following:
 December 31,
 20232022
Land$35,216 $32,656 
Buildings436,460 427,962 
Leasehold improvements4,058,987 3,925,244 
Equipment and information systems, including internally developed software4,125,235 3,759,274 
New center and capital asset projects in progress177,149 376,633 
 8,833,047 8,521,769 
Less accumulated depreciation(5,759,514)(5,265,372)
 $3,073,533 $3,256,397 
Depreciation and amortization expenses are computed using the straight-line method over the useful lives of the assets estimated as follows: buildings, 25 years to 40 years; leasehold improvements, the shorter of ten years or the expected lease term; and equipment and information systems, including internally developed software, principally three years to 15 years. Depreciation expense on property and equipment was $736,474, $721,133 and $667,755 for 2023, 2022 and 2021, respectively.
Interest on debt incurred during the development of new centers and other capital asset projects is capitalized as a component of the asset cost based on the respective in-process capital asset balances. Interest capitalized was $9,178, $12,677 and $15,275 for 2023, 2022 and 2021, respectively.