Segment Reporting (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
Segment Reporting Information [Line Items]
Gross inpatient revenues									$ 19,763,315	$ 18,170,937	$ 17,277,976
Gross outpatient revenues									7,613,277	6,828,975	6,091,262
Total net revenues	1,800,846	1,816,369	1,834,975	1,831,632	1,764,927	1,680,353	1,723,084	1,793,036	7,283,822	6,961,400	6,760,222
Income (loss) before allocation of corporate overhead and income taxes									869,332	763,663	696,336
Allocation of corporate overhead									0	0	0
Income (loss) after allocation of corporate overhead and before income taxes									869,332	763,663	696,336
Total assets	8,311,723				8,200,843				8,311,723	8,200,843	7,665,245
Acute Care Hospital Services
Segment Reporting Information [Line Items]
Gross inpatient revenues									13,469,269	12,406,567	11,770,248
Gross outpatient revenues									6,828,307	6,134,615	5,431,146
Total net revenues									3,576,369	3,461,416	3,423,957
Income (loss) before allocation of corporate overhead and income taxes									342,191	337,385	352,931
Allocation of corporate overhead									(184,444)	(162,056)	(131,225)
Income (loss) after allocation of corporate overhead and before income taxes									157,747	175,329	221,706
Total assets	3,125,626				2,984,169				3,125,626	2,984,169	2,782,102
Behavioral Health Services
Segment Reporting Information [Line Items]
Gross inpatient revenues									6,294,046	5,764,370	5,507,728
Gross outpatient revenues									744,510	646,177	606,876
Total net revenues									3,667,967	3,460,141	3,308,862
Income (loss) before allocation of corporate overhead and income taxes									895,869	838,603	729,142
Allocation of corporate overhead									(89,447)	(84,597)	(62,710)
Income (loss) after allocation of corporate overhead and before income taxes									806,422	754,006	666,432
Total assets	4,966,182				4,979,965				4,966,182	4,979,965	4,373,379
Other
Segment Reporting Information [Line Items]
Gross outpatient revenues									40,460	48,183	53,240
Total net revenues									39,486	39,843	27,403
Income (loss) before allocation of corporate overhead and income taxes									(368,728)	(412,325)	(385,737)
Allocation of corporate overhead									273,891	246,653	193,935
Income (loss) after allocation of corporate overhead and before income taxes									(94,837)	(165,672)	(191,802)
Total assets	$ 219,915				$ 236,709				$ 219,915	$ 236,709	$ 509,764