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Limited health literacy is associated with higher rates of hospitalization. However, the prevalence and etiology of limited health literacy among hospitalized adults and the compensatory strategies used are not known.The aims of this study were to determine the prevalence and demographic associations of limited health literacy in hospitalized patients and to identify the perceived etiology and use of any compensatory strategies.A cross-sectional study was implemented of a consecutive sample of hospitalized adults admitted to the Internal Medicine Hospitalist Service at a 440-bed academic medical center (n = 103) in Vermont. Health literacy was determined using the short form of the Test of Functional Health Literacy in Adults. Demographic data, perceived etiology of difficulties in reading or understanding health information, and use of compensatory strategies were self-reported.Sixty percent of medical inpatients have limited health literacy. Thirty-six percent of patients with limited health literacy attribute this to difficulties with vision. Sixty-two percent of all medical inpatients rely on help from a health professional, and 23% look to a family member when faced with challenges in reading or understanding health information.The prevalence of limited health literacy is high in hospitalized medical patients. Further study of the timing and methods of communicating information to hospitalized patients is warranted. Assuring that the patient and/or family understand the postdischarge plans will be an important step to improving quality and safety.