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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, 2013
Sep. 30, 2013
Jun. 30, 2013
Mar. 31, 2013
Dec. 31, 2012
Sep. 30, 2012
Jun. 30, 2012
Mar. 31, 2012
Dec. 31, 2013
Dec. 31, 2012
Dec. 31, 2011
Receivables [Abstract]                      
Gross patient service revenue                 $ 6,702,484 $ 5,691,790 $ 4,851,500
Contractual adjustments and uncollectibles                 (4,695,232) (3,994,924) (3,362,081)
Hospital contract administrative fees                 146,760 119,746 98,829
Net patient service revenue $ 567,387 $ 554,730 $ 529,180 $ 502,715 $ 471,332 $ 473,134 $ 449,530 $ 422,616 $ 2,154,012 $ 1,816,612 $ 1,588,248