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Intangible assets and goodwill (Details 1) - Carrying Amounts [Member] - BRL (R$)
R$ in Thousands
Dec. 31, 2023
Dec. 31, 2022
IfrsStatementLineItems [Line Items]    
Goodwill R$ 1,334,699 R$ 1,257,045
Licenses with indefinite useful life 2,776,077 2,189,814
Cash generating units 5,584,082 4,814,424
I P T A N Instituto De Ensino Superior Presidente Trancredo De Almeida Neves S A [Member]    
IfrsStatementLineItems [Line Items]    
Goodwill 17,446 17,446
Licenses with indefinite useful life 57,214 57,214
Cash generating units 125,974 126,024
Instituto De Educacao Superior Do Vale Do Parnaiba S A [Member]    
IfrsStatementLineItems [Line Items]    
Goodwill 27,956 27,956
Licenses with indefinite useful life 81,366 81,366
Cash generating units 126,996 129,305
Centro De Ciencias Em Saude De Itajuba S A [Member]    
IfrsStatementLineItems [Line Items]    
Goodwill 4,664 4,664
Licenses with indefinite useful life 56,737 56,737
Cash generating units 54,550 53,540
Instituto De Ensino Superior Do Piaui S A [Member]    
IfrsStatementLineItems [Line Items]    
Goodwill 73,838 73,838
Licenses with indefinite useful life 179,693 179,693
Cash generating units 332,104 322,968
F A D E P Faculdade Educacional De Pato Branco Ltda [Member]    
IfrsStatementLineItems [Line Items]    
Goodwill 49,661 49,661
Licenses with indefinite useful life 70,606 70,606
Cash generating units 148,032 153,100
Instituto Educacional Santo Agostinho S A [Member]    
IfrsStatementLineItems [Line Items]    
Goodwill 58,903 58,903
Licenses with indefinite useful life 144,507 144,507
Cash generating units 322,061 314,967
Institutode Pesquisae Ensino Medicodo Estadode Minas Gerais Ltda [member]    
IfrsStatementLineItems [Line Items]    
Goodwill 87,647 87,647
Licenses with indefinite useful life
Cash generating units 183,862 192,079
Instituto Paraensede Educacaoe Cultura Ltda [Member]    
IfrsStatementLineItems [Line Items]    
Goodwill
Licenses with indefinite useful life 108,000 108,000
Cash generating units 157,984 148,067
Uni Redentor [member]    
IfrsStatementLineItems [Line Items]    
Goodwill 77,662 77,662
Licenses with indefinite useful life 121,477 121,477
Cash generating units 234,054 242,600
Uni S L [Member]    
IfrsStatementLineItems [Line Items]    
Goodwill 4,420 4,420
Licenses with indefinite useful life 273,795 273,795
Cash generating units 401,143 398,492
F E S A R [Member]    
IfrsStatementLineItems [Line Items]    
Goodwill 71,664 71,664
Licenses with indefinite useful life 141,616 141,616
Cash generating units 244,412 244,084
FCMPB [member]    
IfrsStatementLineItems [Line Items]    
Goodwill 110,483 110,483
Licenses with indefinite useful life 235,018 235,018
Cash generating units 402,140 415,453
I T P A C Garanhuns [Member]    
IfrsStatementLineItems [Line Items]    
Goodwill
Licenses with indefinite useful life 108,000 108,000
Cash generating units 116,162 112,628
Medcel And C B B W [Member]    
IfrsStatementLineItems [Line Items]    
Goodwill 179,830 169,975
Licenses with indefinite useful life
Cash generating units 238,921 279,684
Practice Management Tools And Electronic Prescription [Member]    
IfrsStatementLineItems [Line Items]    
Goodwill 106,774 106,774
Licenses with indefinite useful life
Cash generating units 221,171 216,297
Clinical Decision Software [Member]    
IfrsStatementLineItems [Line Items]    
Goodwill 87,018 87,018
Licenses with indefinite useful life
Cash generating units 147,897 153,526
Cliquefarma [Member]    
IfrsStatementLineItems [Line Items]    
Goodwill 6,588 6,588
Licenses with indefinite useful life
Cash generating units 18,789 20,045
Unifip Moc [Member]    
IfrsStatementLineItems [Line Items]    
Goodwill 87,777 87,777
Licenses with indefinite useful life 190,247 190,247
Cash generating units 361,383 369,007
Unigranrio [member]    
IfrsStatementLineItems [Line Items]    
Goodwill 169,173 169,173
Licenses with indefinite useful life 421,538 421,538
Cash generating units 833,665 854,861
RXPRO [member]    
IfrsStatementLineItems [Line Items]    
Goodwill 29,809 29,809
Licenses with indefinite useful life
Cash generating units 34,748 36,675
Glic [member]    
IfrsStatementLineItems [Line Items]    
Goodwill 8,288 15,587
Licenses with indefinite useful life
Cash generating units 23,721 31,022
Del Rey [Member]    
IfrsStatementLineItems [Line Items]    
Goodwill 75,098
Licenses with indefinite useful life 586,263
Cash generating units R$ 854,313