Investments in debt and equity securities - Additional Information (Detail) - Investments in mutual funds and common stock - USD ($) $ in Thousands	9 Months Ended
Sep. 30, 2019	Sep. 30, 2018
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Pre-tax Net Gain (Loss) recognized in Income Statement	$ 2,776	$ 1,597
Pre-tax Realized Gain (Loss) on Securities Arising During Period	586	4,101
Net Increase (Decrease) in Unrealized Gain on Equity Securities due to changes in Fair Value	$ 2,190	$ 2,504

Amount of unrealized and realized gain (loss) on investment in equity security measured at fair value with change in fair value recognized in net income (FV-NI).

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 321
-SubTopic 10
-Section 50
-Paragraph 4
-URI http://asc.fasb.org/extlink&oid=116654751&loc=SL75117546-209714

+ Details

Name:	us-gaap_EquitySecuritiesFvNiGainLoss
Namespace Prefix:	us-gaap_
Data Type:	xbrli:monetaryItemType
Balance Type:	credit
Period Type:	duration

- Definition

Amount of realized gain from sale of investment in equity security measured at fair value with change in fair value recognized in net income (FV-NI).

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 321
-SubTopic 10
-Section 50
-Paragraph 4
-URI http://asc.fasb.org/extlink&oid=116654751&loc=SL75117546-209714

+ Details

Name:	us-gaap_EquitySecuritiesFvNiRealizedGain
Namespace Prefix:	us-gaap_
Data Type:	xbrli:monetaryItemType
Balance Type:	credit
Period Type:	duration

- Definition

Amount of unrealized gain on investment in equity security measured at fair value with change in fair value recognized in net income (FV-NI).

+ References

+ Details

Name:	us-gaap_EquitySecuritiesFvNiUnrealizedGain
Namespace Prefix:	us-gaap_
Data Type:	xbrli:monetaryItemType
Balance Type:	credit
Period Type:	duration

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

No definition available.

+ Details

Name:	us-gaap_ScheduleOfTradingSecuritiesAndOtherTradingAssetsLineItems
Namespace Prefix:	us-gaap_
Data Type:	xbrli:stringItemType
Balance Type:	na
Period Type:	duration

- Details

Name:	us-gaap_InvestmentTypeAxis=dva_MutualFundsAndCommonStockMember
Namespace Prefix:
Data Type:	na
Balance Type:
Period Type: