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Accounts Receivable and Net Patient Service Revenue - Schedule of Net Patient Service Revenue (Detail) (USD $)
In Thousands, unless otherwise specified
 3 Months Ended 12 Months Ended
Dec. 31, 2012
Sep. 30, 2012
Jun. 30, 2012
Mar. 31, 2012
Dec. 31, 2011
Sep. 30, 2011
Jun. 30, 2011
Mar. 31, 2011
Dec. 31, 2012
Dec. 31, 2011
Dec. 31, 2010
Revenues [Line Items]                      
Gross patient service revenue                 $ 5,691,790 $ 4,851,500 $ 4,140,312
Contractual adjustments and uncollectibles                 (3,994,924) (3,362,081) (2,825,827)
Hospital contract administrative fees                 119,746 98,829 87,074
Net patient service revenue $ 471,332 $ 473,134 $ 449,530 $ 422,616 $ 404,898 $ 407,665 $ 393,402 $ 382,283 $ 1,816,612 $ 1,588,248 $ 1,401,559