Long-term debt (Detail) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended
Jun. 30, 2024	Jun. 30, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Total debt principal outstanding	$ 9,048,195	$ 9,048,195	$ 8,445,980
Discount Premium And Deferred Financing Costs	(58,642)	(58,642)	(54,347)
Carrying amount of long-term debt, net of unamortized discounts	8,989,553	8,989,553	8,391,633
Less current portion	(537,991)	(537,991)	(123,299)
Total long-term debt	$ 8,451,562	$ 8,451,562	8,268,334
Debt interest rate during period	4.27%	4.39%
Long-term debt, weighted average interest rate, at point in time	4.33%	4.33%
4.625% Senior Notes
Debt Instrument [Line Items]
Senior Notes	$ 2,750,000	$ 2,750,000	2,750,000
Debt Instrument, Maturity Date		Jun. 01, 2030
Debt interest rate during period		4.625%
Debt Instrument, Fair Value Disclosure	2,488,750	$ 2,488,750
3.75% Senior Notes
Debt Instrument [Line Items]
Senior Notes	1,500,000	$ 1,500,000	1,500,000
Debt Instrument, Maturity Date		Feb. 15, 2031
Debt interest rate during period		3.75%
Debt Instrument, Fair Value Disclosure	1,280,625	$ 1,280,625
Acquisition obligations and other notes payable
Debt Instrument [Line Items]
Acquisition obligations and other notes payable	$ 92,129	$ 92,129	102,328
Debt instrument, maturity date, description		2024-2036
Long-term debt, weighted average interest rate, at point in time	6.73%	6.73%
Acquisition obligations and other notes payable, fair value	$ 92,129	$ 92,129
Financing lease obligations
Debt Instrument [Line Items]
Financing lease obligations	$ 244,262	$ 244,262	255,491
Debt instrument, maturity date, description		2025-2040
Finance lease, weighted average discount rate, percent	4.63%	4.63%
Change Healthcare Temporary Funding Assistance
Debt Instrument [Line Items]
Debt interest rate during period		0.00%
CHC Temporary Funding Assistance, Fair Value	$ 392,984	$ 392,984
CHC Temporary Funding Assistance	$ 392,984	392,984
CHC Repayment Terms	within 45 business
Term Loan A-1
Debt Instrument [Line Items]
Secured Debt	$ 1,218,750	1,218,750	1,234,375
Debt Instrument, Fair Value Disclosure	1,212,656	1,212,656
Debt Instrument, Periodic Payment, Principal		$ 15,625
Term Loan A-1 \| SOFR
Debt Instrument [Line Items]
Debt Instrument, Description of Variable Rate Basis		Base + 1.75%
Term Loan B-1
Debt Instrument [Line Items]
Secured Debt	949,819	$ 949,819	$ 2,603,786
Debt Instrument, Maturity Date		Aug. 12, 2026
Debt Instrument, Fair Value Disclosure	$ 949,819	$ 949,819
SOFR Plus Interest Rate Margin	0.11%
Debt Instrument, Periodic Payment, Principal		$ 13,716
Prepayment of Term Loan B 1	$ 728,653
Constructive Financing Cash Outflows	$ 722,351
Term Loan B-1 \| SOFR
Debt Instrument [Line Items]
Debt Instrument, Description of Variable Rate Basis		Base + 1.75%
Term Loan A-1 and Revolver
Debt Instrument [Line Items]
SOFR Plus Interest Rate Margin	0.10%
Debt Instrument Period Before Maturity Date When Unpaid Amount Triggers Change In Due Date	May 13, 2026
Debt Instrument, Periodic Payment Terms, Date Balloon Payment to be Paid	Apr. 28, 2028

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