First of all, while Hornsby has stated that he was concerned about Garcia's drug use and health in general, I don't believe he's said that was the reason he "left" the Dead. Bruce was a pretty big star on his own at the time and it was always understood that he would just stay long enough to help with the transition to Vince Welnick on keyboards. He had his own career and band to get back to.
I'm not sure how Bruce would have fit with the band had he become the permanent keyboard player. He only played the grand piano with the Dead (and occasional accordian), so I'm not familiar with his othe keyboard/synth abilities. But I'm sure his chops are probably just fine. On piano, I found Bruce to be a more melodic player than Godchaux while Brent's forte was the organ. He also did a lot more soloing than other Dead keyboard players. Hornsby would often engage in extended jams into the drums/space segment with various combinations of band members. I remember one from MSG in '90 where he, Jerry and Vince did a gorgeous jam out of Fooish Heart:
https://www.youtube.com/watch?v=YOqKSpd_pv0