Segments - Reconciliation of Other Expenses from Segments to Consolidated (Detail) (USD $) In Thousands, unless otherwise specified	3 Months Ended		6 Months Ended
	Jun. 30, 2013	Jun. 30, 2012	Jun. 30, 2013	Jun. 30, 2012
Segment Reporting Information [Line Items]
Depreciation and amortization expense	$ 24,986	$ 23,719	$ 49,626	$ 46,990
Operating Segments | Product Development
Segment Reporting Information [Line Items]
Depreciation and amortization expense	18,601	16,508	37,048	32,387
Operating Segments | Integrated Healthcare Services
Segment Reporting Information [Line Items]
Depreciation and amortization expense	5,267	6,119	10,620	12,411
Corporate, Non-Segment | Corporate
Segment Reporting Information [Line Items]
Depreciation and amortization expense	$ 1,118	$ 1,092	$ 1,958	$ 2,192