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Revenue - Schedule of U.S. Revenue and Percentage Generated by Each Payor Type (Detail) - USD ($)
$ in Thousands
 3 Months Ended 12 Months Ended
Dec. 31, 2019
Sep. 30, 2019
Jun. 30, 2019
Mar. 31, 2019
Dec. 31, 2018
Sep. 30, 2018
Jun. 30, 2018
Mar. 31, 2018
Dec. 31, 2019
Dec. 31, 2018
Dec. 31, 2017
Health Care Organization, Receivable and Revenue Disclosures [Line Items]                      
Revenue before provision for doubtful accounts                 $ 3,107,462 $ 3,012,442 $ 2,877,234
Provision for doubtful accounts                     (40,918)
Revenue $ 780,232 $ 777,251 $ 789,362 $ 760,617 $ 743,547 $ 760,916 $ 765,738 $ 742,241 3,107,462 3,012,442 2,836,316
U.S. Facilities [Member]                      
Health Care Organization, Receivable and Revenue Disclosures [Line Items]                      
Revenue before provision for doubtful accounts                 2,008,381 1,904,695 1,850,556
Provision for doubtful accounts                     (40,712)
Revenue                 $ 2,008,381 $ 1,904,695 $ 1,809,844
Revenue before provision for doubtful accounts, Percentage                 100.00% 100.00% 100.00%
U.S. Facilities [Member] | Commercial [Member]                      
Health Care Organization, Receivable and Revenue Disclosures [Line Items]                      
Revenue before provision for doubtful accounts                 $ 565,350 $ 573,089 $ 569,242
Revenue before provision for doubtful accounts, Percentage                 28.20% 30.10% 30.80%
U.S. Facilities [Member] | Medicare [Member]                      
Health Care Organization, Receivable and Revenue Disclosures [Line Items]                      
Revenue before provision for doubtful accounts                 $ 294,691 $ 280,340 $ 281,270
Revenue before provision for doubtful accounts, Percentage                 14.70% 14.70% 15.20%
U.S. Facilities [Member] | Medicaid [Member]                      
Health Care Organization, Receivable and Revenue Disclosures [Line Items]                      
Revenue before provision for doubtful accounts                 $ 1,007,102 $ 893,644 $ 796,375
Revenue before provision for doubtful accounts, Percentage                 50.10% 46.90% 43.00%
U.S. Facilities [Member] | Self-Pay [Member]                      
Health Care Organization, Receivable and Revenue Disclosures [Line Items]                      
Revenue before provision for doubtful accounts                 $ 118,716 $ 134,054 $ 169,727
Revenue before provision for doubtful accounts, Percentage                 5.90% 7.10% 9.20%
U.S. Facilities [Member] | Other [Member]                      
Health Care Organization, Receivable and Revenue Disclosures [Line Items]                      
Revenue before provision for doubtful accounts                 $ 22,522 $ 23,568 $ 33,942
Revenue before provision for doubtful accounts, Percentage                 1.10% 1.20% 1.80%