Uncompensated Care (Detail) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Health Care Trust Fund [Line Items]
Uncompensated care	$ 998,770	$ 1,045,572	$ 955,748
Uncompensated care, percentage	100.00%	100.00%	100.00%
Charity Care
Health Care Trust Fund [Line Items]
Uncompensated care	593,474	778,268	804,301
Uncompensated care, percentage	59.00%	74.00%	84.00%
Uninsured Discounts
Health Care Trust Fund [Line Items]
Uncompensated care	$ 405,296	$ 267,304	$ 151,447
Uncompensated care, percentage	41.00%	26.00%	16.00%