Segments - Depreciation and Amortization Expense (Detail) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Segment Reporting Information [Line Items]
Depreciation and amortization expense	$ 107,504	$ 98,288	$ 92,004
Operating Segments [Member] | Product Development [Member]
Segment Reporting Information [Line Items]
Depreciation and amortization expense	82,047	68,825	68,029
Operating Segments [Member] | Integrated Healthcare Services [Member]
Segment Reporting Information [Line Items]
Depreciation and amortization expense	20,475	24,366	19,785
Corporate, Non-Segment [Member]
Segment Reporting Information [Line Items]
Depreciation and amortization expense	$ 4,982	$ 5,097	$ 4,190